Surgical instrument including rotating end effector and rotation-limiting structure

ABSTRACT

A surgical instrument for applying tacks to tissue. The surgical instrument includes a handle assembly, an elongated portion, an outer tube, an end effector, a rotation assembly, and a rotation-limiting structure. The rotation assembly is configured to rotate at least a portion of the outer tube about a first longitudinal axis and with respect to the handle assembly. The rotation assembly includes a rotation knob rotationally fixed to a proximal portion of the outer tube. The rotation-limiting structure is disposed in mechanical cooperation with at least one of the rotation assembly and the handle assembly, and is configured to limit an amount of rotation of the outer tube with respect to the handle assembly.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation-in-part of U.S. patent applicationSer. No. 13/974,371 filed on Aug. 23, 2013, which is acontinuation-in-part of U.S. patent application Ser. No. 13/974,338filed on Aug. 23, 2013, which is a continuation-in-part of U.S. patentapplication Ser. No. 13/930,770, filed on Jun. 28, 2013, and thedisclosures of each of the above-identified applications are herebyincorporated by reference in their entirety.

BACKGROUND

Technical Field

The present disclosure relates to surgical instruments, devices and/orsystems for performing endoscopic surgical procedures and methods of usethereof. More specifically, the present disclosure relates to surgicalinstruments, devices and/or systems including an end effector that isable to articulate, rotate and have a limited amount of rotation.

Background of Related Art

During laparoscopic or endoscopic surgical procedures, access to asurgical site is typically achieved through a small incision or througha narrow cannula inserted through a small entrance wound in a patient.Because of limited area to access the surgical site, many endoscopicsurgical devices include mechanisms for articulating or rotating thetool assembly or the end effector of the device.

In surgical instruments that are used to apply tacks or anchors havinghelical threads, for example, an additional challenge exists whenattempting to rotate the end effector, as the tacks are also configuredto rotate through the end effector, through a surgical mesh, and intotissue, for instance.

Accordingly, a need exists for tack-applying surgical instruments whichinclude the ability for its end effector to articulate and rotate, whilealso limiting the overall amount of rotation to prevent the prematureejection of tacks and to prevent timing issues when attempting to ejecttacks.

SUMMARY

The present disclosure relates to a surgical instrument configured toapply tacks to tissue. The surgical instrument includes a handleassembly, an elongated portion, an outer tube, an end effector, arotation assembly, and a rotation-limiting structure. The elongatedportion extends distally from the handle assembly and defines a firstlongitudinal axis. The outer tube extends distally from the handleassembly. The end effector is disposed adjacent a portion of theelongated portion and is configured to house a plurality of tackstherein. The end effector defines a second longitudinal axis. Therotation assembly is configured to rotate at least a portion of theouter tube about the first longitudinal axis and with respect to thehandle assembly. The rotation assembly includes a rotation knobrotationally fixed to a proximal portion of the outer tube. Therotation-limiting structure is disposed in mechanical cooperation withat least one of the rotation assembly and the handle assembly, and isconfigured to limit an amount of rotation of the outer tube with respectto the handle assembly.

In embodiments, the rotation-limiting structure includes at least oneprojection extending from a portion of the rotation knob. It isdisclosed that the rotation-limiting structure includes at least one lipdisposed within the handle assembly. It is further disclosed that afirst projection of the at least one projection is configured to contacta first lip of the at least one lip upon a predetermined amount ofrotation of the rotation knob in a first direction. Additionally, it isdisclosed that a second projection of the at least one projection isconfigured to contact a second lip of the at least one lip upon apredetermined amount of rotation of the rotation knob in a seconddirection. It is also disclosed that the predetermined amount ofrotation of the rotation knob in the first direction is about 45°, andthe predetermined amount of rotation of the rotation knob in the seconddirection is about 45°.

In disclosed embodiments, the rotation knob includes a non-circulartransverse cross-section, where the transverse cross-section is takenperpendicular to the first longitudinal axis.

It is further disclosed that at least a portion of the end effector isrotationally fixed with respect to the outer tube.

Additionally, it is disclosed that the rotation assembly is configuredto rotate at least a portion of the end effector about the secondlongitudinal axis.

In disclosed embodiments, the surgical instrument further includes aplurality of helical tacks disposed at least partially within the endeffector.

It is also disclosed that the surgical instrument further includes anarticulation assembly configured to move the end effector from a firstposition where the second longitudinal axis is coaxial with the firstlongitudinal axis, to a second position where the second longitudinalaxis is disposed at an angle with respect to the first longitudinalaxis. It is further disclosed that the articulation assembly includes anarticulation knob that is rotatable about the first longitudinal axiswith respect to the proximal portion of the outer tube.

The present disclosure also relates to a method of applying surgicaltacks from a surgical instrument to tissue. The method includesarticulating an end effector of the surgical instrument from a firstposition where the end effector is longitudinally aligned with anelongated portion of the surgical instrument, to a second position wherethe end effector is disposed at an angle with respect to the elongatedportion. The method further includes rotating the end effector a firstamount in a first direction with respect to a handle assembly of thesurgical instrument. The method further includes limiting the amount ofrotation of the end effector in the first direction to a firstpredetermined amount of rotation, and ejecting at least one surgicaltack from the surgical instrument.

In disclosed embodiments, the method further includes limiting the firstpredetermined amount of rotation to about 45°.

Embodiments of the method further include rotating the end effector asecond amount in a second direction with respect to a handle assembly ofthe surgical instrument. It is disclosed that the method also includeslimiting the amount of rotation of the end effector in the seconddirection to a second predetermined amount of rotation, and that thesecond predetermined amount of rotation is about 45°.

In embodiments, articulating the end effector is performed independentlyof rotating the end effector.

BRIEF DESCRIPTION OF THE DRAWINGS

Various aspects of the present disclosure are described hereinbelow withreference to the drawings, which are incorporated and constitute a partof this specification, wherein:

FIG. 1 is a perspective view of a surgical anchor for use in anendoscopic surgical device in accordance with the present disclosure;

FIG. 2 is a side, elevational view of the surgical anchor of FIG. 1;

FIG. 3 is a distal, end view of the surgical anchor of FIGS. 1 and 2;

FIG. 4 is a side, elevational view, partially broken away, of thesurgical anchor of FIGS. 1-3;

FIG. 5 is an endoscopic surgical device according to an aspect of thepresent disclosure;

FIG. 6 is a perspective view, with parts separated, of the endoscopicsurgical device of FIG. 5;

FIG. 7 is an enlarged view of the indicated area of detail of FIG. 6;

FIG. 8 is a rear perspective view, with a first housing half-sectionremoved therefrom, of a handle assembly of the endoscopic surgicaldevice of FIG. 5;

FIG. 9 is a front perspective view, with a second housing half-sectionremoved therefrom, of a handle assembly of the endoscopic surgicaldevice of FIG. 5;

FIG. 10 is a rear perspective view, with a second housing half-sectionand trigger removed therefrom, of the handle assembly of the endoscopicsurgical device of FIG. 5;

FIG. 11 is a rear perspective view, with parts separated, and with asecond housing half-section removed therefrom, of the handle assembly ofthe endoscopic surgical device of FIG. 5;

FIG. 12 is a perspective view of a pinion gear of the handle assembly ofFIGS. 8-11;

FIG. 13 is a perspective view of a button and slider of the handleassembly of FIGS. 8-11;

FIG. 14 is a perspective view of a bevel gear of the handle assembly ofFIGS. 8-11;

FIG. 15 is a front perspective view, with parts separated, of anendoscopic assembly of the endoscopic surgical device of FIG. 5;

FIG. 16 is an enlarged view of the indicated area of detail of FIG. 15;

FIG. 17 is a rear perspective view of the endoscopic surgical device ofFIG. 5;

FIG. 18 is an enlarged view of the indicated area of detail of FIG. 17;

FIG. 19 is a perspective view of the distal end of the endoscopicsurgical device of FIG. 5 with an end effector shown separatedtherefrom;

FIG. 20 is a rear perspective view of the end effector of FIG. 19;

FIG. 21 is a rear perspective view of the end effector of FIG. 20, withan outer tube removed therefrom;

FIG. 22 is a perspective view of the end effector of FIGS. 20 and 21,with an outer tube separated therefrom;

FIG. 23 is a perspective view of the end effector of FIGS. 20-22, withan outer tube removed therefrom and with parts partially separated;

FIG. 24 is a perspective view of an inner tube of the end effector ofFIGS. 20-23, with a plurality of anchors of FIGS. 1-4 shown separatedtherefrom;

FIG. 25 is a cross-sectional view, as taken along 25-25 of FIG. 22;

FIG. 26 is a cross-sectional view, as taken along 26-26 of FIG. 22;

FIG. 27 is a cross-sectional view, as taken along 27-27 of FIG. 22;

FIG. 28 is a perspective view of the end effector of FIGS. 20-27 with ashipping wedge shown attached thereto;

FIG. 29 is a cross-sectional view as taken through 29-29 of FIG. 28;

FIG. 30 is a cross-sectional view as taken through 30-30 of FIG. 29;

FIG. 31 is a longitudinal, cross-sectional, elevational view of theendoscopic surgical device of FIG. 5;

FIG. 32 is an enlarged view of the indicated area of detail of FIG. 31;

FIG. 33 is an enlarged view of the indicated area of detail of FIG. 31;

FIG. 34 is a cross-sectional view as taken though 34-34 of FIG. 31;

FIG. 35 is an enlarged view of the indicated area of detail of FIG. 34;

FIG. 36 is an enlarged view of the indicated area of detail of FIG. 34;

FIG. 37 is an enlarged view of the indicated area of detail of FIG. 36;

FIG. 38 is a cross-sectional view as taken though 34-34 of FIG. 33;

FIG. 39 is a cross-sectional view as taken though 34-34 of FIG. 33;

FIG. 40 is a cross-sectional view as taken though 34-34 of FIG. 33;

FIG. 41 is a cross-sectional view as taken though 34-34 of FIG. 33;

FIG. 42 is an enlarged elevational view of the handle assembly shown inFIGS. 9 and 10, illustrating an operation of the slider;

FIG. 43 is a longitudinal, cross-sectional view the end effector and theendoscopic assembly of the endoscopic surgical device of FIG. 5,illustrating a first step in the decoupling thereof;

FIG. 44 is a longitudinal, cross-sectional view the end effector and theendoscopic assembly of the endoscopic surgical device of FIG. 5,illustrating a second step in the decoupling thereof;

FIG. 45 is a longitudinal, cross-sectional view an articulation knob ofthe handle assembly of FIGS. 5-11, illustrating a rotation thereof;

FIG. 46 is a longitudinal, cross-sectional view of a distal end of theendoscopic surgical device illustrating an articulation of the endeffector relative to the endoscopic assembly due to a rotation of thearticulation knob;

FIG. 47 is an enlarged elevational view of the handle assembly shown inFIGS. 9 and 10, illustrating an operation of an audible/tactile feedbackmember of the handle assembly, shown in an position following an initialactuation of a trigger;

FIG. 48 is an enlarged elevational view of the handle assembly shown inFIGS. 9 and 10, illustrating an operation of the audible/tactilefeedback member of the handle assembly, shown in an position following acomplete actuation of the trigger;

FIG. 49 is a longitudinal, cross-sectional view of the end effector anda distal end of endoscopic assembly, illustrating an implanting of asurgical anchor through a surgical mesh and into underlying tissue;

FIG. 50 is a perspective illustration showing the anchoring and/orfixation of a surgical mesh to underlying tissue with a plurality ofsurgical fasteners;

FIG. 51 is a perspective view of a distal end of another embodiment ofan endoscopic surgical device illustrating an alternate end effector andan alternate complementary elongate body portion, wherein the endeffector is shown separated from the elongate body portion;

FIG. 52 is a perspective view of the end effector of the endoscopicsurgical device of FIG. 51;

FIG. 53 is a perspective view of the end effector of FIG. 52 with anouter tube of the end effector removed therefrom;

FIG. 54 is a perspective view of a portion of the endoscopic surgicaldevice of FIG. 51 with a proximal end of the end effector shownconnected to a distal end of the elongate body portion, the elongatebody portion shown in an advanced position;

FIG. 55 is a perspective view of a portion of the endoscopic surgicaldevice of FIG. 51 with the proximal end of the end effector shownconnected to the distal end of the elongate body portion, the elongatebody portion shown in a retracted position;

FIG. 56 is a side, elevational view of an embodiment of a shipping wedgein accordance with the present disclosure;

FIG. 57A is a top, perspective view of the shipping wedge of FIG. 56with the end effector of FIG. 52 shown disposed within and coupled tothe shipping wedge;

FIG. 57B is a side, cross-sectional view as taken along 57B-57B of FIG.57A;

FIG. 58A is a top, perspective view of the shipping wedge of FIG. 56with the end effector of FIG. 52 shown coupled to the shipping wedge andwith the elongate body portion of the endoscopic surgical device of FIG.51 being positioned within the shipping wedge relative to the endeffector;

FIG. 58B is a side, cross-sectional view as taken along 58B-58B of FIG.58A;

FIGS. 59-62 are enlarged, progressive, side, cross-sectional viewsillustrating the end effector being coupled and secured to the elongatebody portion and removed from the shipping wedge;

FIG. 63 is a side view of a tack applier in accordance with anotherembodiment of the present disclosure;

FIG. 64A is a proximal end view of the tack applier of FIG. 63illustrating an end effector thereof that has been articulated, androtated in a counter-clockwise direction;

FIG. 64B is a proximal end view of the tack applier of FIGS. 63 and 64Aillustrating the end effector thereof that has been articulated, andthat has not been rotated;

FIG. 64C is a proximal end view of the tack applier of FIGS. 63-64Billustrating the end effector thereof that has been articulated, androtated in a clockwise direction;

FIG. 65 is a side view of a handle assembly of the tack applier of FIG.64B illustrating a rotation knob that is in a non-rotated position;

FIG. 66 is a side view of the handle assembly of the tack applier ofFIG. 64C illustrating the rotation knob rotated in a clockwise or firstdirection;

FIG. 67 is a cut-away side view of the handle assembly of the tackapplier of FIGS. 64B and 65 illustrating the rotation knob in thenon-rotated position of FIG. 65;

FIG. 68 is a cut-away side view of the handle assembly of the tackapplier of FIGS. 64C and 66 illustrating the rotation knob rotated inthe clockwise or first direction of FIG. 66;

FIGS. 69 and 69A are perspective views of portions of the handleassembly shown in FIG. 67 illustrating the rotation knob in thenon-rotated position of FIGS. 65 and 67;

FIG. 69B is a cut-away perspective view taken along line 69B-69B in FIG.69A illustrating the rotation knob in the non-rotated position;

FIG. 70 is a perspective view of a portion of the handle assembly shownin FIG. 68 illustrating the rotation knob rotated in the clockwise orfirst direction of FIGS. 66 and 68;

FIG. 71 is a perspective view of a distal end of the tack applier ofFIG. 64B showing an anchor is a distal position, and corresponding tothe rotation knob being in the non-rotated position of FIGS. 65, 67 and69;

FIG. 72 is a distal end view of a distal end of the tack applier of FIG.71;

FIG. 73 is a distal end view of a distal end of the tack applier of FIG.64C, corresponding to the rotation knob being rotated in a clockwisedirection;

FIG. 74 is a distal end view of a distal end of the tack applier of FIG.64A, corresponding to the rotation knob being rotated in acounter-clockwise direction; and

FIG. 75 is a distal end view of a distal end of a tack applier that hasbeen rotated beyond a predetermined amount in a clockwise direction.

DETAILED DESCRIPTION OF EMBODIMENTS

Embodiments of the presently disclosed surgical instrument are describedin detail with reference to the drawings, in which like referencenumerals designate identical or corresponding elements in each of theseveral views. As used herein the term “distal” refers to that portionof the endoscopic surgical device that is farther from the user, whilethe term “proximal” refers to that portion of the endoscopic surgicaldevice that is closer to the user.

Non-limiting examples of endoscopic surgical devices which may includearticulation joints according to the present disclosure include manual,mechanical and/or electromechanical surgical tack appliers (i.e.,tackers) and the like.

Referring initially to FIGS. 1-4, a surgical anchor or tack for use withthe surgical tack applier of the present disclosure is illustrated andgenerally designated as anchor 100. As seen in FIGS. 1-4, anchor 100includes a head section 110, a mesh retention section 120, and athreaded tissue-snaring section 130. Head section 110 includes a pair ofopposing threaded sections 112 a, 112 b having respective radially,outer, helical head threads 114 a, 114 b, and a pair of opposing open orslotted sections 116 a, 116 b. A distal surface of head section 110 isformed onto or integral with a proximal end of mesh retention section120.

Mesh retention section 120 of anchor 100 extends from and between adistal end or surface of head section 110 and a proximal end oftissue-snaring section 130. Mesh retention section 120 functions tolock, anchor or otherwise retain a surgical mesh (not shown) on toanchor 100 when anchor 100 is screwed into the mesh to a depth past aproximal-most segment 138 of tissue-snaring thread 132 of tissue-snaringsection 130. This is achieved because there is no thread located in meshretention section 120 that would allow anchor 100 to be unscrewed orbacked out from the mesh.

Mesh retention section 120 has a cylindrical or conical transversecross-sectional profile. Mesh retention section 120 includes atransverse radial dimension, relative to a central longitudinal axis ofanchor 100, that is smaller than a transverse radial dimension of headsection 110, and smaller than a transverse radial dimension ofproximal-most segment 138 of tissue-snaring thread 138.

Threaded tissue-snaring section 130 of anchor 100 includes helicalthreads 132 formed onto a tapered truncated body section 134. A distalpoint or tip 136 defines the terminus of the distal most tissue-snaringthread 132.

As seen in FIG. 4, body section 134 of tissue-snaring section 130 istapered, i.e., becoming smaller toward the distal end of threadedtissue-snaring section 130, and terminates or truncates to a distaltruncation point “TP”, prior to reaching an apex or tip of anchor 100.Body section 134 includes a concave taper such that, for a given length,a minimum diameter body section 134 is defined upon truncation thereofwhich is approximately less than 0.01 inches.

Anchor 100 includes a transverse dimension “D”, of a distal-most threadin the threaded tissue-snaring section 130 which is as large as designconstraints will allow or approximately greater than 0.040 inches. Inaccordance with the present disclosure, a small truncated body diameterand a large value of “D” minimizes tissue indentation. Thetissue-snaring threads 132 terminate at distal tip 136, which is distalof the truncation point “TP” of body section 134.

By providing a distal tip 136 extending distally of truncation point“TP” of tissue-snaring section 130, a penetration of the mesh, by anchor100, is eased; and an indentation of the mesh into relatively softtissue, by anchor 100, is minimized, as compared to an anchor having anon-truncated body with tapered threads.

For a given force applied to a surgical mesh by the surgeon, exerting adistal force on a tack applier the larger the dimension “D” of anchor100 the less the pressure exerted to cause indentation of an underlyingtissue and surgical mesh.

Anchor 100 is non-cannulated and is constructed from a suitablebioabsorbable material, such as, polylactide, polyglycolide. Anchor 100is formed from a proprietary biocompatible co-polymer (Lactomer USS L1,Boehringer Ingelheim LR 704 S, or Boehringer Ingelheim LG-857).

Turning now to FIGS. 5-49, an endoscopic surgical device, in the form ofan endoscopic surgical tack applier or tacker, is shown generally as200. Tack applier 200 includes a handle assembly 210, and an endoscopicassembly 230 extending from handle assembly 210 and configured to storeand selectively release or fire a plurality of anchors 100 therefrom andinto mesh “M” overlying tissue “T”. (see FIG. 50).

As seen in FIGS. 5-14, handle assembly 210 includes a handle housing 212formed from a first half-section 212 a and a second half section 212 bjoined to one another. First half-section 212 a and second half section212 b of handle housing 212 may be joined to one another using knowmethods by those of skill in the art, including and not limited towelding, fasteners (i.e., screws) and the like.

Handle assembly 210 includes a trigger 214 pivotably connected to handlehousing 212, at a location remote from endoscopic assembly 230. Handleassembly 210 includes a biasing member 222 configured for maintainingtrigger 214 in an extended or un-actuated position. Biasing member 222is also configured to have a spring constant sufficient to returntrigger 214 to the un-actuated position.

Trigger 214 defines a gear rack 214 a formed thereon at a locationopposite or remote from the pivot of trigger 214. Gear rack 214 a oftrigger 214 is configured for operative engagement with a pinion gear216 rotatably supported in handle housing 212. Gear rack 214 a andpinion gear 216 are dimensioned such that one complete squeeze oftrigger 214 results in one complete revolution of pinion gear 216.

As seen in FIGS. 7, 9, 11, 47 and 48, handle assembly 210 includes atiming system 270 associated therewith. Timing system 270 includes araceway 214 c formed in a surface of trigger 214. Raceway 214 c definesa plurality of steps 214 d therealong, and a home position 214 e (FIGS.9 and 48) formed therein.

Timing system 270 includes a resilient and deflectable arm 272 having afirst end 272 a operative connected or disposed in raceway 214 c andthat is in contact with steps 214 d as first end 272 a thereof travelsaround raceway 214 c. Deflectable arm 272 further includes a second end272 b that is connected to handle housing half 212 b. Raceway 214 c oftrigger is configured such that when trigger 214 is in a fullyun-actuated position, first end 272 a of deflectable arm 272 is locatedin the home position 214 e of raceway 214 c.

In operation, as seen in FIGS. 47 and 48, when trigger 214 is in thefully un-actuated position, as mentioned above, first end 272 a ofdeflectable arm 272 is located in the home position 214 e of raceway 214c. Then, as trigger 214 is actuated, first end 272 a of arm 272 ridesthrough and/or along raceway 214 c (in a single direction) formed intrigger 214. First end 272 a of arm 272 moves uni-directionally oversteps 214 d of raceway 214 c, such that, if trigger 214 is releasedafter a partial squeeze, first end 272 a of arm 272 can not movebackwards or in reverse through raceway 214 c due to steps 214 d andtrigger 214 can not return to the fully un-actuated position.

As so configured and operable, and as will be described in detail below,end effector or loading unit 300 may only be removed and replaced whentrigger 214 is in the fully un-actuated, home and locked position. Assuch, an end effector or loading unit 300 can not be removed or replacedor loaded on/in handle assembly 200 while trigger 214 is in ashort-stroked condition (i.e., partially actuated).

Additionally, as first end 272 a of arm 272 moves over steps 214 d ofraceway 214 c, first end 272 a of arm 272 snaps over steps 214 d andcreates an audible sound/click and/or a tactile vibration for thesurgeon. It is contemplated that timing system 270 includes sufficientsteps 214 d in raceway 214 c so as to create an audible/tactileindication when trigger 214 is in a fully un-actuated home or lockoutposition (for loading/unloading end effector or loading unit 300); aftertrigger 214 has been fully actuated to fire a singe surgical anchor 100;and when trigger 214 is reset to the fully un-actuated home position(wherein trigger 214 may once again be locked) and ready to fire anothersurgical anchor 100.

As seen in FIGS. 7 and 9-12, handle assembly 210 includes a pinion gear216 having an arm 216 a extending radially therefrom and a cam or ramp216 b extending/projecting from arm 216 a. Cam 216 b includes a frontend 216 c having a height defining a shoulder, and tail end 216 dtapering into arm 216 a.

As seen in FIGS. 7-11 and 14, handle assembly 210 further includes afirst bevel gear 218, in the form of a crown gear, operativelyengaged/associated with pinion gear 216. First bevel gear 218 defines anarcuate slot 218 a formed in a face 218 d thereof for selectivelyreceiving and engaging cam 216 b of pinion gear 216. Slot 218 a includesa front end wall 218 b configured to engage front end 216 c of cam 216 bof pinion gear 216, and tapers along a length thereof to be flush withface 218 d of first bevel gear 218.

In use, as trigger 214 is actuated, gear rack 214 a thereof is moved inan axial or arcuate first direction to thereby rotate pinion gear 216,meshed therewith, in a first direction. As pinion gear 216 is rotated inthe first direction, front end 216 c of cam 216 b of pinion gear 216 isrotated in a first direction until front end 216 c engages or contactsfront end wall 218 a of slot 218 b of first bevel gear 218. After frontend 216 c of pinion gear 216 engages or contacts front end wall 218 a ofslot 218 b of first bevel gear 218, continued rotation of pinion gear216 in the first direction results in concomitant rotation of firstbevel gear 218 in a first direction. At this point, first bevel gear 218continues to rotate in the first direction so long as trigger 214 isbeing actuated and gear rack 214 a is moving in the first direction.

When actuation of trigger 214 is stopped, either prior to completeactuation or following complete actuation, rotation of first bevel gear218, in the first direction, is also stopped.

Upon the completion of a partial or complete actuation of trigger 214and a release thereof, gear rack 214 a thereof is moved in a seconddirection (opposite the first direction) to thereby rotate pinion gear216 in a second direction. As pinion gear 216 is rotated in the seconddirection rear end 216 d of cam 216 b thereof slides along slot 218 b offirst bevel gear 218, and if the rotation in the second direction issufficient, slides out of slot 218 b of bevel gear 218 and along face218 d of first bevel gear 218.

If trigger 214 was fully actuated, a complete release of trigger 214,and return to the fully un-actuated position, wherein first end 272 a ofdeflectable arm 272 is returned to the home position 214 e of raceway214 c, will result in pinion gear 216 making a complete revolution, inthe second direction, until front end 216 c of cam 216 b of pinion gear216 clears front end wall 218 a of slot 218 b of first bevel gear 218 tothereby re-enter slot 218 b of first bevel gear 218.

As seen in FIGS. 8 and 11, handle assembly 210 of tack applier 200 isprovided with a ratchet mechanism 260 which is configured to inhibit orprevent inner shaft assembly 238 from backing-out or reversing afteranchor 100 has been at least partially driven into tissue. Ratchetmechanism 260 includes, as seen in FIGS. 8 and 11, a series of ratchetteeth 218 f formed on a rear surface 218 e of first bevel gear 218.

Ratchet mechanism 260 further includes a spring clip 262 secured withinhandle assembly 210. Spring clip 262 includes a resilient finger 262 aconfigured for engagement with ratchet teeth 218 f formed on rearsurface 218 e of first bevel gear 218.

Each ratchet tooth 218 f includes a shallow angled side and a steepangled side. In this manner, resilient finger 262 a of spring clip 262engages with ratchet teeth 218 f in such a manner that as first bevelgear 218 is rotated, in a first direction resilient, finger 262 a ofspring clip 262 cams over the shallow angled side of ratchet teeth 218 fAlso, if first bevel gear 218 is rotated in a second direction (oppositeto the first direction), resilient finger 262 a of spring clip 262 stopsagainst the steep angled side of ratchet teeth 218 f thereby preventingor inhibiting first bevel gear 218 from rotating in the seconddirection. As such, any reverse rotation or “backing-out” of anchor 100or inner shaft assembly 238 (tending to cause first bevel gear 218 torotate in the second direction), during a driving or firing stroke, isinhibited or prevented.

In an alternate embodiment, first bevel gear 218 may be maintained fromrotating in the second or opposite direction, upon the rotation ofpinion gear 216, in the second direction, due to a coefficient of staticfriction between first bevel gear 218 and a surface of handle housing212, or a coefficient of static friction between first bevel gear 218and a pin upon which first bevel gear 218 is supported, which will tendto maintain first bevel gear 218 stationary. Such a configuration andassembly functions as a ratchet mechanism or the like for tack applier200.

With reference to FIGS. 6, 7 and 9-11, handle assembly 210 furtherincludes a second or pinion-bevel gear 220 having gear teeth 220 aoperatively engaged or meshed with gear teeth 218 c formed at the outerradial edge and on front face 218 d of first bevel gear 218.Pinion-bevel gear 220 is secured to a proximal end of an inner shaftassembly 238 of anchor retaining/advancing assembly 230 (see FIG. 15).In an embodiment, pinion-bevel gear 220 is keyed to proximal end ofinner shaft assembly 238 of anchor retaining/advancing assembly 230 suchthat inner shaft assembly 238 is capable of axial displacement relativeto pinion-bevel gear 220 and is prevented from rotation relative topinion-bevel gear 220.

In use, as described above, upon squeezing of trigger 214, gear rack 214a thereof causes pinion gear 216 to rotate in the first direction.Rotation of pinion gear 216, in the first direction, results in rotationof first bevel gear 218 in the first direction and, in turn, rotation ofpinion-bevel gear 220 in a first direction. As pinion-bevel gear 220 isrotated in the first direction, pinion-bevel gear 220 transmits therotation to inner shaft assembly 238 of anchor retaining/advancingassembly 230.

As seen in FIGS. 5-11 and 13, handle assembly 210 includes a button 240supported on handle housing 212 and being configured to permit andinhibit actuation of trigger 214, and for effectuating aloading/retention and a release/removal of an end effector 300 to anchorretaining/advancing assembly 230. Button 240 includes a pin 240 aslidably supported in handle housing 212. Pin 240 a is oriented in adirection orthogonal to the longitudinal axis of anchorretaining/advancing assembly 230. As seen in FIGS. 38-41, pin 240 a hasa length such that when button 240 is in a first position, a first endof pin 240 a extends from a first side of handle housing 212, and whenbutton 240 is in a second position, a second end of pin 240 a extendsfrom a second side of handle housing 212.

As seen in FIGS. 13 and 38-41, button 240 includes a plate 240 bsupported on and connected to pin 240 a. Plate 240 b defines an elongateslot 240 c therein, through which a stem 220 a of pinion-bevel gear 220extends. Elongate slot 240 c of plate 240 b defines a major axis whichis parallel relative to a longitudinal axis of pin 240 a. In use, as pin240 a is moved between the first position and the second position, plate240 b is moved between respective first and second positions.

Button 240 includes a first detent or recess 240 d defined in plate 240b that is engaged by a biasing member 242 when button 240 is in thefirst position, and a second detent or recess 240 e defined in plate 240b that is engaged by biasing member 242 when button 240 is in the secondposition. The engagement of biasing member 242 in either first detent240 d or second detent 240 e of button 240 functions to help maintainbutton 240 in either the first or second position.

In an embodiment, biasing member 242 may be in the form of a plungerspring, and, as seen in FIGS. 33 and 42, in another embodiment, biasingmember 242 may be in the form of a torsion spring. A torsion spring iscontemplated over a plunger spring in order to reduce overall costs ofsurgical tacker 200.

As seen in FIGS. 8, 13, 33 and 38-42, button 240 includes a first wall240 f extending from plate 240 b, and a second wall 240 g extending fromplate 240 b. In use, when button 240 is in the first position, firstwall 240 f thereof blocks or inhibits movement of a load/release slider244, and when button 240 is in the second position, first wall 240 fthereof permits movement of load/release slider 244. Similarly, in use,when button 240 is in the second position (only achievable when trigger214 is in a fully un-actuated or home position), second wall 240 gthereof blocks or inhibits actuation of trigger 214 by second wall 240 gextending into a notch 214 b of trigger 214; and when button 240 is inthe first position, second wall 240 f is clear of notch 214 b of trigger214 to permit actuation of trigger 214.

As seen in FIGS. 5-11, 13 and 38-42, handle assembly 210 includes aload/release slider 244 slidably supported on handle housing 212 andbeing configured to effectuate a loading/retention and a release/removalof an end effector 300, in the form of a single use loading unit(loading unit) or disposable loading unit (DLU), as will be discussed ingreater detail below. Slider 244 includes a first stem 244 a extendingproximally therefrom and toward button 240. Specifically, first stem 244a of slider 244 is in axial registration with first wall 240 f extendingfrom plate 240 b of button 240 when button 240 is in the first position(see FIG. 39), and out of axial registration with first wall 240 f ofbutton 240 when button 240 is in the second position (see FIG. 41).

Slider 244 further includes a second stem 244 b extending therefrom in adirection toward inner shaft assembly 238 of anchor retaining/advancingassembly 230. As seen in FIGS. 15 and 42, inner shaft assembly 238supports a pair of axially spaced apart radial flanges 238 d, 238 ewhich bookend (i.e., one flange being distal and one flange beingproximal of second stem 244 b).

In use, as seen in FIGS. 41 and 42, when button 240 is in the secondposition (wherein trigger 214 is locked in the fully un-actuatedposition) such that first stem 244 a of slider 244 is out of axialregistration with first wall 240 f of button 240, slider 244 is free tomove between a first or distal position and a second or proximalposition. As slider 244 is moved from the first position to the secondposition thereof, second stem 244 b of slider 244 exerts a force onproximal radial flange 238 d of inner shaft assembly 238 to urge innershaft assembly 238 proximally from a respective first position to arespective second position. It follows that as slider 244 is moved fromthe second position to the first position thereof, second stem 244 b ofslider 244 exerts a force on distal radial flange 238 e of inner shaftassembly 238 to urge inner shaft assembly 238 distally from therespective second position to the respective first position.

In accordance with the present disclosure, as inner shaft assembly 238is moved between the respective first and second positions thereof,inner shaft assembly 238, being connected to coupling member 238 cresults in connecting member 238 c also moving between a respectivefirst position and a respective second position.

Slider 244 may be biased to the first or distal position by a biasingmember 245 (see FIG. 42).

As seen in FIGS. 5, 6, 8, 15, 17, 33-35 and 45, handle assembly 210includes an articulation knob 246 rotatably supported on handle housing212. Articulation knob 246 defines an inner helical thread 246 a. Innerhelical thread 246 a meshingly receives or engages an outer thread 247 aof a connection nut 247 that is non-rotatably connected to proximal tubeportion 234 a of inner tube assembly 234 of anchor retaining/advancingassembly 230. Connection nut 247 may be keyed to articulation knob 246so as to not rotate relative to articulation knob 246 as articulationknob 246 is rotated. Alternatively, the surgeon may manually grip adistal end of connection nut 247 (which is projecting/extending distallyof articulation knob 246) as articulation knob 246 is rotated.

In use, as seen in FIGS. 45 and 46, with connection nut 247 retainedagainst rotation about the longitudinal axis, as articulation knob 246is rotated in a first direction, connection nut 247 travels along innerhelical thread 246 a of articulation knob 246 to cause innerarticulation tube assembly 234 to move in a respective first or distalaxial direction; and as articulation knob 246 is rotated in a seconddirection, connection nut 247 travels along inner helical thread 246 aof articulation knob 246 to cause inner articulation tube assembly 234to move in a respective second or proximal axial direction. Inaccordance with the present disclosure, rotation of articulation knob246 in the respective first and second directions results in thearticulating and straightening of anchor retaining/advancing assembly230, as will be discussed in greater detail below.

Turning now to FIGS. 15, 16, 32, 33 and 42-46, as seen therein,endoscopic assembly 230 includes an outer tube 231, an outer supporttube assembly 232 disposed within outer tube 231, an inner articulationtube assembly 234, and an inner shaft assembly 238. Outer support tubeassembly 232 includes a proximal support tube portion 232 a secured toand extending from handle housing 212, and a distal support tube portion232 b pivotally connected to proximal tube portion 232 a by a pivot pin232 c (see FIGS. 15 and 16) at an articulation joint 250.

As seen in FIGS. 15, 16, 43 and 44, distal support tube portion 232 bsupports a ball detent 233 in an outer surface thereof. Ball detent 233functions to selectively secure and retain end effector 300 toendoscopic assembly 230. In use, as will be discussed in greater detailbelow, as seen in FIGS. 37 and 42, ball detent 233 is acted on by anouter camming surface/relief 238 c ₁ of coupling member 238 which actson ball detent 233 to move ball detent 233 radially outward when innershaft assembly 238 is a distal position.

Inner articulation tube assembly 234 includes a proximal tube portion234 a concentrically and slidably disposed within proximal tube portion232 a of outer support tube assembly 232. As seen in FIG. 33, proximalend 234 b of proximal tube portion 234 a is non-rotatably connected toconnection nut 247.

Inner articulation tube assembly 234 includes an articulation link 235having a proximal end 235 a pivotally connected to a distal end ofproximal tube portion 234 a, and a distal end 235 b pivotally connectedto distal tube portion 232 b of outer support tube assembly 232. Distalend 235 b of articulation link 235 is pivotally connected to distal tubeportion 232 b of outer support tube assembly 232 at a location offsetfrom the central longitudinal axis of anchor retaining/advancingassembly 230, in a direction substantially away from pivot pin 232 c ofarticulation joint 250.

In operation, as seen in FIGS. 45 and 46, upon an axial translation ofproximal tube portion 234 a, for example in a proximal direction, due toa rotation of articulation knob 246 and proximal axial movement ofconnection nut 247 as described above, proximal tube portion 234 a actsor pulls on articulation link 235 to cause articulation link 235 totranslate in a proximal direction. As articulation link 235 is axiallytranslated in a proximal direction, articulation link 235 acts or pullson distal tube portion 232 b of outer support tube assembly 232 to causedistal tube portion 232 b to pivot about a pivot axis of pivot pin 232c. As distal tube portion 232 b is pivoted, distal tube portion 232 bcauses end effector 300 to be moved to an articulated orientationrelative to the central longitudinal axis of anchor retaining/advancingassembly 230.

It follows that upon an axial translation of proximal tube portion 234 ain a distal direction, due to a distal movement of slider 244, asdescribed above, proximal tube portion 234 a acts or pushes onarticulation link 235 to cause articulation link 235 to translate in adistal direction. As articulation link 235 is axially translated in adistal direction, articulation link 235 acts or pushes on distal tubeportion 232 b of outer support tube assembly 232 to cause distal tubeportion 232 b to pivot about a pivot axis of pivot pin 232 c. As distaltube portion 232 b is pivoted, distal tube portion 232 b causes endeffector 300 to be returned to a non-articulated orientation relative tothe central longitudinal axis of anchor retaining/advancing assembly230.

In accordance with the present disclosure, distal tube portion 232 b ofanchor retaining/advancing assembly 230 is pivotable in a singledirection relative to proximal tube portion 232 a of anchorretaining/advancing assembly 230.

With reference to FIGS. 15, 19, 32, 33 and 35-46, inner actuation shaftassembly 238 includes a proximal rigid shaft portion 238 a, a distalflexible shaft portion 238 b non-rotatably connected to and extendingfrom a distal end of proximal rigid shaft portion 238 a, and a couplingmember 238 c non-rotatably connected to a distal end of distal flexibleshaft portion 238 b. Second or pinion-bevel gear 220 is non-rotatablyconnected to a proximal end of proximal rigid shaft portion 238 a ofinner actuation shaft assembly 238. Inner actuation shaft assembly 238is configured such that distal flexible shaft portion 238 b extendsacross and beyond articulation joint 250.

Desirably, coupling member 238 c is rotatably and slidably supported indistal tube portion 232 b of outer support tube assembly 232 so as toaccommodate and/or account for variations in length of distal flexibleshaft portion 238 b when distal flexible shaft portion 238 b is in aflexed condition. Coupling member 238 c is substantially tongue shapedand extends in a distal direction distally from distal tube portion 232b of outer support tube assembly 232. Coupling member 238 c isconfigured for non-rotatable connection to inner tube 338 of endeffector 300, as will be discussed in greater detail below.

Distal flexible shaft portion 238 b is fabricated from a torsionallystiff and flexible material, such as, for example, stainless steel.

It is contemplated that distal flexible shaft portion 238 b may have anouter diameter of about 0.08′. Meanwhile, anchor retaining/advancingassembly 230 has an outer diameter of about 0.22′. A ratio of the outerdiameter of distal flexible shaft portion 238 b to the outer diameter ofanchor retaining/advancing assembly 230 is about 2.8.

Inner actuation shaft assembly 238 is configured to perform at least apair of functions, a first function relating to the securing and releaseof an end effector or loading unit 300 to distal tube portion 232 b ofouter support tube assembly 232 upon an axial translation thereof, and asecond function relating to the firing of fasteners 100 from endeffector or loading unit 300 when end effector or loading unit 300 iscoupled to distal tube portion 232 b of outer support tube assembly 232upon a rotation thereof.

In order to prepare surgical tacker 200 for receipt of end effector orloading unit 300 or to replace a spent end effector or loading unit 300with a new end effector or loading unit 300, as seen in FIGS. 38-44, andas mentioned above, trigger 214 must be in a fully un-actuated position.With trigger 214 in the fully un-actuated position, button 240 is movedfrom the first position to the second position (as described above) suchthat trigger 214 is prevented from actuation and such that slider 244 isfree to move. With button 240 in the second position, slider 244 ismoved from the first position to the second position (as describedabove). As slider 244 is moved to the second position, second stem 244 bof slider 244 exerts a force on proximal radial flange 238 d of innershaft assembly 238 to urge inner shaft assembly 238, and in turncoupling member 238 a thereof, proximally from a respective firstposition to a respective second position. As coupling member 238 a ismoved from the first position to the second position, ball detent 233 isfree to drop or move radially inward of outer tube 231 as outer cammingsurface/relief 238 c ₁ of coupling member 238 is moved into axialregistration with ball detent 233. With ball detent 233 free to drop ormove radially inward, end effector or loading unit 300 may be fullycoupled to distal support tube portion 232 b of anchorretaining/advancing assembly 230.

Once again, as mentioned above, as so configured and operable, endeffector or loading unit 300 may only be removed and replaced whentrigger 214 is in the fully un-actuated, home and locked position. Assuch, end effector or loading unit 300 can not be removed or replaced orloaded while trigger 214 is in a short-stroked condition (i.e.,partially actuated).

With a new end effector or loading unit 300 fully coupled to distalsupport tube portion 232 b of anchor retaining/advancing assembly 230,slider 244 is moved from the second position to the first position tosecure or lock end effector or loading unit 300 to distal support tubeportion 232 b of anchor retaining/advancing assembly 230. In particular,as slider 244 is moved to the first position, second stem 244 b ofslider 244 exerts a force on distal radial flange 238 e of inner shaftassembly 238 to urge inner shaft assembly 238, and in turn couplingmember 238 a thereof, distally from second position to first position.As coupling member 238 a is moved from the second position to the firstposition, ball detent 233 is urged by outer camming surface/relief 238 c₁ of coupling member 238 to move ball detent 233 radially outward. Asball detent 233 moves radially outward a portion of ball detent 233enters an aperture 332 c of end effector or loading unit 300 to secureend effector or loading unit 300 to distal support tube portion 232 b ofanchor retaining/advancing assembly 230. With end effector or loadingunit 300 coupled to distal support tube portion 232 b of anchorretaining/advancing assembly 230, button 240 is moved from the secondposition to the first position (as described above) such that slider 244is prevented from actuation and such that trigger 214 is free to move.

Turning now to FIGS. 5, 6, 15, 17-27, 32, 36, 37, 43, 44 and 46, endeffector 300, in the form of a loading unit or DLU, is shown and will bedescribed herein. End effector 300, as mentioned above, is selectivelyconnectable to distal tube portion 232 b of outer support tube assembly232.

End effector or loading unit 300 includes an outer tube 332 defining alumen 332 a therethrough and being configured and dimensioned (i.e.,substantially rectangular or dog bone shaped) to receive distal tubeportion 232 b of outer support tube assembly 232 and coupling member 238c of anchor retaining/advancing assembly 230 therein. As seen in FIG.19, outer tube 332 defines a proximal key slot 332 b for engagement witha key 232 c formed in distal tube portion 232 b of outer support tubeassembly 232. In use, when end effector or loading unit 300 is connectedto distal tube portion 232 b of outer support tube assembly 232 key slot332 b and key 232 c engage with one another to properly align endeffector or loading unit 300 and anchor retaining/advancing assembly 230to one another.

End effector or loading unit 300 further includes a spiral or coil 336fixedly disposed within a distal portion of outer tube 332. A pair ofaxially spaced apart retention rings 337 a, 337 b is also fixedlydisposed within outer tube 332 at a location proximal of coil 336.

End effector or loading unit 300 also includes an inner tube 338rotatably disposed within coil 336. Inner tube 338 defines a lumentherethrough, and includes a proximal end portion 338 a and a splineddistal end portion 338 b. Proximal end portion 338 a of inner tube 338is configured and dimensioned to slidably receive coupling member 238 cof anchor retaining/advancing assembly 230 therein. Inner tube 338includes a plurality of retention tabs 338 c projecting radially outwardtherefrom and which snap beyond one of the pair of retention rings 337a, 337 b, when inner tube 338 is assembled with outer tube 332. In thismanner, outer tube 332 and inner tube 338 are axially fixed and yetrotatable relative to one another.

Distal end portion 338 a of inner tube 338 is slotted, defining a pairof tines 338 a ₁ and a pair of channels 338 a ₂. Distal end portion 338a of inner tube 338 is capable of accepting a plurality of anchors 100within inner tube 338. In particular, anchors 100 are loaded into endeffector or loading unit 300 such that the pair of opposing threadedsections 112 a, 112 b of anchors 100 extend through respective channels338 a ₂ of distal end portion 338 a of inner tube 338 and are slidablydisposed within the groove of coil 336, and the pair of tines 338 a ₁ ofdistal end portion 338 a of inner tube 338 are disposed within the pairof slotted sections 116 a, 116 b of anchors 100. Each anchor 100 isloaded into end effector or loading unit 300 such that adjacent anchors100 are not in contact with one another so as to not damage distal tips136.

In use, as inner tube 338 is rotated, about its longitudinal axis, withrespect to coil 336, the pair of tines 338 a ₁ of inner tube 338transmit the rotation to anchors 100 and advance anchors 100 distallyowing to head threads 114 a, 114 b of anchors 100 engaging with coil336.

In an operation of surgical tacker 200, as seen in FIG. 49, with endeffector or loading unit 300 operatively connected to distal tubeportion 232 b of outer support tube assembly 232 of anchorretaining/advancing assembly 230, as inner shaft assembly 238 is rotateddue to an actuation of trigger 214, as described above, said rotation istransmitted to inner tube 338 of end effector or loading unit 300 viacoupling member 238 c of anchor retaining/advancing assembly 230. Again,as inner tube 338 is rotated, about its longitudinal axis, with respectto coil 336, the pair of tines 338 a ₁ of inner tube 338 transmit therotation to the entire stack of anchors 100 and advance the entire stackof anchors 100 distally, owing to head threads 114 a, 114 b of anchors100 engaging with coil 336.

In accordance with the present disclosure, the components of surgicaltacker 200, and anchors 100 are dimensioned such that a single completeand full actuation of trigger 214 results in a firing of a singe anchor100 (i.e., the distal-most anchor of the stack of anchors 100 loaded inend effector or loading unit 300) from end effector or loading unit 300.

Surgical tacker 200 may be repeatedly fired to fire anchors from endeffector 300 until the surgical procedure is complete or until endeffector or loading unit 300 is spent of anchors 100. If end effector orloading unit 300 is spent of anchors 100, and if additional anchors 100are required to complete the surgical procedure, spent end effector orloading unit 300 may be replaced with a new (i.e., loaded with anchors100) end effector or loading unit 300.

As seen in FIGS. 40-44, in order to replace spent end effector orloading unit 300 with a new end effector or loading unit 300, withtrigger 214 in the fully un-actuated position (as described above, thesurgeon actuates or slides button 244 to release the spent end effectoror loading unit 300, decouples end effector or loading unit 300 fromanchor retaining/advancing assembly 230, loads or connects a new endeffector or loading unit 300 to anchor retaining/advancing assembly 230(by fitting proximal end portion 338 a of inner tube 338 over couplingmember 238 c of anchor retaining/advancing assembly 230), and releasesbutton 244 to retain the new end effector or loading unit 300 on anchorretaining/advancing assembly 230. Since trigger 214 is in the fullyun-actuated position with the loading of a new end effector or loadingunit 300, timing system 270 is re-set such that each fully actuation oftrigger 214 results in the firing of a single anchor 100.

It is contemplated that end effector or loading unit 300 may only beconnected or coupled to distal tube portion 232 b of outer support tubeassembly 232 of anchor retaining/advancing assembly 230 while anchorretaining/advancing assembly 230 is in the non-articulated condition.

In accordance with the present disclosure, with end effector or loadingunit 300 connected or coupled to distal tube portion 232 b of outersupport tube assembly 232 of anchor retaining/advancing assembly 230,articulation knob 246 is rotated or held in place such that anchorretaining/advancing assembly 230 is in a non-articulated condition.

Additionally, in accordance with the present disclosure, with endeffector or loading unit 300 connected or coupled to distal tube portion232 b of outer support tube assembly 232 of anchor retaining/advancingassembly 230, end effector or loading unit 300 is introduced into atarget surgical site while in the non-articulated condition. With endeffector or loading unit 300 disposed within the target surgical site,the surgeon may remotely articulate end effector or loading unit 300relative to anchor retaining/advancing assembly 230. Specifically, asseen in FIGS. 45 and 46, the surgeon rotates articulation knob 246 toaxially displace connection nut 247 and proximal tube portion 234 a ofinner articulation tube assembly 234 to move in the proximal axialdirection. As proximal tube portion 234 a is moved in the proximal axialdirection, proximal tube portion 234 a acts or pulls on articulationlink 235 to cause articulation link 235 to translate in a proximaldirection. As articulation link 235 is axially translated in a proximaldirection, articulation link 235 acts or pulls on distal tube portion232 b of outer support tube assembly 232 to cause distal tube portion232 b to pivot about a pivot axis of pivot pin 232 c. As distal tubeportion 232 b is pivoted, distal tube portion 232 b causes end effector300 to be moved to an articulated orientation relative to the centrallongitudinal axis of anchor retaining/advancing assembly 230.

Turning now to FIGS. 28-30, in accordance with the present disclosure, ashipping wedge 400 may be provided which is configured and dimensionedto releasably connect to end effector or loading unit 300, to inhibitpremature rotation of inner tube 338 of end effector or loading unit300, and to help facilitate loading/unloading of end effector or loadingunit 300 to/from distal tube portion 232 b of anchor retaining/advancingassembly 230.

Shipping wedge 400 includes a handle portion 402 and a coupling member404 integrally formed with or secured to handle portion 402. Couplingmember 404 is substantially tubular having a substantially C-shapedtransverse cross-sectional profile. Coupling member 404 defines alongitudinally extending opening or gap 404 a therealong. Handle portion404 defines a longitudinal axis that is substantially orthogonal to thelongitudinal axis of coupling member 404.

Coupling member 404 has a diameter sufficient to accommodate endeffector or loading unit 300 therein and along. Also, gap 404 a ofcoupling member 404 has a dimension, which together with the materialsof construction of at least coupling member 404, allows for couplingmember 404 to be snapped-over end effector or loading unit 300. It isenvisioned that at least coupling member 404 may be fabricated from apolymeric or other substantially rigid and resilient material.

As seen in FIGS. 29 and 30, shipping wedge 400 includes a wedge, spikeor nub 406 extending radially into coupling member 404. In particular,wedge 406 extends or projects in a direction substantially parallel tothe longitudinal axis of handle portion 402. Wedge 406 has a lengthsufficient such that, when shipping wedge 400 is attached to endeffector or loading unit 300, wedge 406 enters an aperture 332 d (seeFIGS. 19, 22, 29 and 30) formed in outer tube 332 of end effector orloading unit 300.

Additionally, when shipping wedge 400 is attached to end effector orloading unit 300, wedge 406 extends to be in close proximity to or incontact with proximal end portion 338 a of inner tube 338 of endeffector or loading unit 300. By extending this amount, wedge 406inhibits rotation of inner tube 338 relative to outer tube 332 byblocking or contacting proximal end portion 338 a of inner tube 338 ifinner tube 338 experiences any rotation relative to outer tube 332.

Also, when shipping wedge 400 is attached to end effector or loadingunit 300, and with wedge 406 blocking rotation of inner tube 338 of endeffector or loading unit 300, shipping wedge 400 facilitates aloading/unloading of end effector or loading unit 300 to/from distaltube portion 232 b of anchor retaining/advancing assembly 230. Duringloading of end effector or loading unit 300 to distal tube portion 232 bof anchor retaining/advancing assembly 230, shipping wedge 400 functionsto fix an angular orientation of proximal end portion 338 a of innertube 338 for proper alignment and orientation with coupling member 238 cof anchor retaining/advancing assembly 230.

In accordance with the present disclosure, it is contemplated thathandle assembly 100 may be replaced by an electromechanical controlmodule configured and adapted to drive the flexible drive cables to fireor actuate the surgical device. The electromechanical control module mayinclude at least one microprocessor, at least one drive motorcontrollable by the at least one microprocessor, and a source of powerfor energizing the at least one microprocessor and the at least onedrive motor.

Turning now to FIGS. 51-55, another embodiment of an endoscopic surgicaldevice, in the form of an endoscopic surgical tack applier or tacker, isshown generally as 500. Endoscopic surgical device 500 is similar toendoscopic surgical device 200 and is only described herein to theextent necessary to describe the differences in construction andoperation thereof. Likewise, another embodiment of an end effector isshown generally as 520. End effector 520 is similar to end effector 300and is only described herein to the extent necessary to describe thedifferences in construction and operation thereof.

With reference to FIG. 51, endoscopic surgical device 500 includes anelongate body portion 510 and an end effector 520 (e.g., single useloading unit) that can be selectively secured to a distal end ofelongate body portion 510.

Elongate body portion 510 includes an outer tube 512 and an inneractuation shaft 514 that is slidably positioned within outer tube 512.Outer tube 512 includes an inner surface 512 a and an outer surface 512b. Inner surface 512 a defines a lumen 512 c that extends longitudinallythrough outer tube 512 and supports inner actuation shaft 514. Outertube 512 defines a notch 512 d that extends between and across innersurface 512 a and outer surface 512 b in a distal end of outer tube 512.Inner actuation shaft 514 extends longitudinally through lumen 512 cbetween proximal and distal ends of outer tube 512. The distal end ofinner actuation shaft 514 includes an engagement member 516. An arm ortab 518 extends from engagement member 516. Arm 518 defines a recess 518a that extends at least partially therethrough.

As illustrated in FIGS. 51-53, end effector 520 includes an outer tube522 and a splined inner tube 524 rotatably positioned within outer tube522. Outer tube 522 includes an inner surface 522 a and an outer surface522 b. Inner surface 522 a defines a lumen 522 c that extendslongitudinally through outer tube 522 between proximal and distal endsof outer tube 522. The distal end of outer tube 522 includes a distalopening 522 d. Outer tube 522 defines an opening 522 e that extendsbetween inner surface 522 a and outer surface 522 b in a proximalportion of outer tube 522. Splined inner tube 524 supports a spiral 336that is fixedly disposed within a distal portion of outer tube 522 andabout a pair of tines 530 of the splined inner tube 524, so that thepair of tines 530 and spiral 336 support a plurality of surgical anchors100 that are adapted for selective advancement through end effector 520.

As can be seen in FIG. 53, splined inner tube 524 includes a couplingmember 526 fixedly secured to inner surface 522 a of outer tube 522 at aproximal end thereof and includes a locking tab 526 a that extends froma proximal end of coupling member 526. As described above, splined innertube 524 includes a pair of tines 530 at a distal end thereof and anengagement member 532 at a proximal end thereof. The pair of tines 530includes a first tine 530 a and a second tine 530 b. First and secondtines 530 a, 530 b are spaced apart and define first and second channels530 c, 530 d therebetween that receive a portion of each of theplurality of anchors 100. Engagement member 532 includes an arm or tab534 extending longitudinally therefrom, and a pin 536 projectingperpendicularly to arm 534.

In use, as shown in FIGS. 54 and 55, inner actuation shaft 514 ofelongate body portion 510 is slidably movable relative to outer tube 512between an advanced position (FIG. 54) and a retracted position (FIG.55). In the advanced position, engagement member 516 of inner actuationshaft 514 is exposed or projects from outer tube 512. In the retractedposition, engagement member 516 of inner actuation shaft 514 isconcealed or housed within outer tube 512. More particularly, in theadvanced position, arm 518 of engagement member 516 is extended suchthat recess 518 a is exposed for receiving pin 536 of engagement member532.

To connect end effector 520 to elongate body portion 510, pin 536 ofengagement member 532 is inserted in recess 518 a of engagement member516 so that arm 534 of engagement member 532 is connected to arm 518 ofengagement member 516. After connecting end effector 520 to elongatebody portion 510, inner actuation shaft 514 can be moved to theretracted position which draws both engagement members 532, 516 withinouter tube 512 of elongate body portion 510. As such, locking tab 526 aof end effector 520 is received within notch 512 d of elongate bodyportion 510 to prevent outer tube 522 of end effector 520 from rotatingrelative to elongate body portion 510 upon a rotation of inner actuationshaft 514. Additionally, engagement member 516, 532 are housed withinouter tube 522 of end effector 520, thereby being inhibited fromseparating from one another.

A rotation of inner actuation shaft 114 rotates both engagement members516, 532 relative to outer tubes 512, 522 and coupling member 526 toimpart rotation to splined inner tube 524, and in turn, the pair oftines 530, for distally advancing the plurality of anchors 100 alongspiral 336 and individually deploying each of the plurality of anchors100 out of distal opening 522 d of outer tube 522 of end effector 520.

Turning now to FIG. 56, another embodiment of a shipping wedge is showngenerally as 600. Shipping wedge 600 includes an elongate first body610, and an angled second body 620 that extends from first body 610 atan angle relative to first body 610. More particularly, first body 610defines a longitudinal axis “A” that extends through opposed ends 610 a,610 b of elongate body 610. Angled body 620 defines a longitudinal axis“B” that extends through opposed ends of 620 a, 620 b of angled body620. Longitudinal axes “A” and “B” define an angle “α” therebetween.Although shown in FIG. 56 as an acute angle, angle “α” can be anysuitable angle.

Referring to FIGS. 57A and 57B, first body 610 includes a pair ofopposed sidewalls 612 a that is connected at a base 612 b. The pair ofopposed sidewalls 612 a defines a channel 614 therebetween to form aU-shape that is dimensioned to receive an elongate body such as elongatebody portion 510 of endoscopic surgical device 500. Channel 614 extendslongitudinally through first body 610. An alignment rib 616 extendsbetween the pair of opposed sidewalls 612 a and defines a passage 616 athat extends through alignment rib 616 and separates alignment rib 616into a pair of segments 616 b.

Angled body 620 includes a pair of opposed sidewalls 622 a that isconnected at a base 622 b. The pair of opposed sidewalls 622 a defines achannel 624 therebetween to form a U-shape that is dimensioned toreceive and retain an end effector, such as, end effector 520 (FIGS. 57Aand 57B). Channel 624 extends longitudinally through angled body 620such that channel 624 is angled relative to channel 614 (see FIG. 57B).Angled body 620 includes a protuberance 626 (e.g., a boss or nub) thatextends from an inner surface 622 c of base 622 b. Protuberance 626 canhave any suitable shape including circular and non-circular (e.g.,elliptical, polygonal, etc.) shapes.

A pair of alignment flanges 618 extend from opposed sidewalls 612 a offirst body 610 and opposed sidewalls 622 a of angled body 620 to formfunnel configurations that facilitate proper alignment of an endoscopicsurgical device such as endoscopic surgical device 500, or portionsthereof, relative to shipping wedge 600. As shown in FIG. 57A, eachalignment flange of the pair of alignment flanges 618 has a curvilineararrangement that extends outwardly from channels 614 and 624.

With continued reference to FIGS. 57A and 57B, although shipping wedge600 can be used with any suitable endoscopic surgical device, in anexemplary use with endoscopic surgical device 500, end effector 520 ofendoscopic surgical device 500 is secured within channel 624 of angledbody 620 (e.g., press fit). Protuberance 626 of angled body 620 ispositioned within opening 522 e of end effector 520 (and/or within firstand/or second channels 530 c, 530 d of end effector 520) to prevent endeffector 520 from translating through channel 624 of angled body 620and/or to prevent end effector 520, or portions thereof (e.g., outerand/or inner tube 522, 524 including the pair of tines 530), fromrotating within channel 624 of angled body 620. As can be appreciated,the protuberance 626 enables end effector 520 to maintain proper timing(e.g., tack/anchor deployment timing) during shipment and/or loadingprocesses of end effector 520. When the end effector 520 is securedwithin channel 624 of angled body 620, pin 536 of end effector 520 isaligned with alignment rib 616.

Referring also to FIGS. 58A-62, to remove end effector 520 from shippingwedge 600, in the advanced position of the elongate body portion 510 ofendoscopic surgical device 500, elongate body portion 510 can bepositioned relative to channel 614 so that the distal end of elongatebody portion 510 is longitudinally aligned with alignment rib 616. Moreparticularly, engagement member 516 of elongate body portion 510 abutsagainst alignment rib 616 of shipping wedge 600 to longitudinally alignarm 518 of engagement member 516 with passage 616 a. Elongate bodyportion 510 is then inserted (e.g., press fit) into channel 614 so thatarm 518 of elongate body portion 510, guided by alignment rib 616 ofshipping wedge 600, moves through passage 616 a toward pin 536 of endeffector 520 (FIGS. 59 and 60). As elongate body portion 510 engages endeffector 520, pin 536 inserts into recess 518 a of arm 518 so that endeffector 520 pivots relative to elongate body portion 510 and out ofchannel 624 of angled body 620 into axial alignment with elongate bodyportion 510 (FIGS. 60 and 61). As end effector 520 pivots out of channel624 of angled body 620, protuberance 626 of angled body 620 separatesfrom opening 522 e of end effector 520.

As seen in FIG. 62, with elongate body portion 510 connected to endeffector 520, elongate body portion 510 can be moved to the retractedposition to draw end effector 520 into engagement with elongate bodyportion 510 to secure the proximal end of end effector 520 within thedistal end of elongate body portion 510. Endoscopic surgical device 500,including both elongate body portion 510 and end effector 520, can thenbe withdrawn from shipping wedge 600, while beneath alignment rib 616,and through channel 614 of shipping wedge 600 to separate endoscopicsurgical device 500 from shipping wedge 600 (FIG. 62). Endoscopicsurgical device 500 can then be used to perform a surgical procedure.

Referring now to FIGS. 63-75, a different embodiment of an endoscopicsurgical device or tack applier is shown and is indicated by referencecharacter 700. Tack applier 700 includes the same or similararticulation capabilities as tack applier 200, as discussed in detailhereinabove. For example, tack applier 700 includes an elongated portionor an anchor retaining/advancing assembly 710, and includes an endeffector 720 that is able to articulate or pivot with respect to thefirst or central longitudinal axis “A-A” of anchor retaining/advancingassembly 710. In addition to these features, end effector 720 isrotatable about the central longitudinal axis “A-A” of anchorretaining/advancing assembly 710. Further, tack applier 700 isconfigured and adapted to limit the amount of rotation of end effector720 along the central longitudinal axis “A-A” of anchorretaining/advancing assembly 710.

With particular reference to FIGS. 63-64C, various views of portions oftack applier 700 are shown with end effector 720 in an articulatedposition, and rotated in varying amounts. Initially, in FIG. 63, a sideview of tack applier 700 is shown. Here, end effector 720 is in anarticulated position and with no amount of rotation. With reference toFIGS. 64A-64C, proximal-to-distal or proximal end views of tack applier700 are shown where end effector 720 is in an articulated position, andend effector 720 is shown in varying amounts of rotation along thecentral longitudinal axis “A-A” of anchor retaining/advancing assembly710. Specifically, in FIG. 64A, tack applier 700 is shown with endeffector 720 in a first articulated position, and rotated in a firstdirection (i.e., counter-clockwise). In FIG. 64B, tack applier 700 isshown with end effector 720 in the first articulated position, andwithout any rotation (corresponding to the position of end effector 720shown in FIG. 63). In FIG. 64C, tack applier 700 is shown with endeffector 720 in the first articulated position, and rotated in a seconddirection (i.e., clockwise). While each of FIGS. 64A-64C illustrates endeffector 720 in a particular articulated position, tack applier 700 isalso capable of rotating end effector 720 when end effector 720 is inany articulated position, including not articulated.

In use, the articulation and rotation ability of tack applier 700 is ofgreat convenience and importance to the surgeon. For example, theability of tack applier 700 to articulate allows the surgeon to accessand apply anchors 100 up to 360° within a patient from a single location(e.g., a single access port) without having to physically move to anopposite side of the patient. The surgeon may, however, need to move(e.g., pivot) tack applier 700 with respect to the patient to achievethe 360° access. On occasion, the movement of tack applier 700 causesits handle assembly to contact the patient (e.g., a patient's leg), thusresulting in interference therebetween and thus limiting the movement ofthe tack applier 700. The ability to rotate the handle assembly of tackapplier 700 with respect to anchor retaining/advancing assembly 710 orcentral longitudinal axis “A-A” allows the handle assembly to move outof the way of the patient to prevent or minimize any interferencetherebetween. Additionally, the ability to rotate the handle assembly oftack applier 700 enables or facilities access to various portions of thepatient (e.g., toward the surgeon) without the surgeon being required tomove (e.g., pivot) the tack applier 700 with respect to the patient, andwithout the surgeon being required to physically move their own positionwith respect to the patient.

Referring now to FIGS. 65 and 66, side views of a handle assembly 730 oftack applier 700 are shown in different stages as related to rotation ofend effector 720. In particular, FIG. 65 is a side view of handleassembly 730 where a rotation assembly 740 is in an initial, non-rotatedposition. In FIG. 66, rotation assembly 740 is in its second rotatedposition, corresponding to the end effector 720 being rotated in thesecond direction (as shown in FIG. 64C, for instance).

With reference to FIGS. 67 and 68, cut-away views of handle assembly 730of tack applier 700 are shown in different stages as related to rotationof end effector 720. In particular, FIG. 67 is a cut away view of handleassembly 730 where a rotation assembly 740 is in an initial, non-rotatedposition, as shown in FIG. 64. In FIG. 68, rotation assembly 740 is inits second rotated position, as shown in FIG. 66, corresponding to theend effector 720 being rotated in the second direction.

FIGS. 69 and 70 show enlarged, perspective views of portions of rotationassembly 740. In FIG. 69, rotation assembly 740 is shown in anon-rotated position, which corresponds to the orientation of rotationassembly 740 shown in FIGS. 64B, 65 and 67. In FIG. 70, rotationassembly 740 is shown in its second rotated position, which correspondsto the orientation of rotation assembly 740 shown in FIGS. 64C, 66 and68.

Rotation assembly 740 includes a rotation knob 744 disposed proximallyof an articulation knob 760. Articulation knob 760 is functionallysimilar to articulation knob 246 discussed hereinabove. Specifically,rotation of articulation knob 760 about the central longitudinal axis ofanchor retaining/advancing assembly 710 causes the end effector 720,which defines a second longitudinal axis “B-B” (FIG. 63), to articulateor pivot with respect to the central longitudinal axis “A-A” of anchorretaining/advancing assembly 710. With particular reference to FIGS.67-70, articulation knob 760 includes a body portion 761, a proximalextension 762 and a proximal flange 764. A longitudinal gap 766 isdefined between a proximal face 761 a of body portion 761 and proximalflange 764.

Rotation knob 744 includes a first body half 744 a and a second bodyhalf 744 b (FIG. 66), which may be releasably engaged (e.g., via a screwconnection, as shown). As illustrated in FIG. 69, first and second bodyhalves 744 a, 744 b each include parts (e.g., one lateral half) forminga distal flange 746, a body portion 748, and a proximal flange 750.Additionally, in the embodiment shown in FIGS. 64A and 64C, for example,rotation knob 744 is non-circular. That is, for instance, rotation knob744 may be oval, oblong, elliptical, etc. In such embodiments whererotation knob 744 is non-circular, is may be easier for the surgeon todetermine if, and how much, the end effector 730 has been rotated basedon the displacement “D” between a lateral edge 745 of rotation knob 744and a wall 731 of handle assembly 730 (see FIGS. 64A and 64C).

Rotation knob 744 is rotationally fixed to a proximal portion 802 of anouter tube 800, such that rotation of rotation knob 744 with respect tohandle assembly 730 causes corresponding rotation of outer tube 800.Additionally, due to the engagement between outer tube 800 and endeffector 720, rotation of outer tube 800 causes a corresponding rotationof end effector 720 along central longitudinal axis “A-A” of anchorretaining/advancing assembly 710. Rotation knob 744 may be pinned orotherwise rotationally fixed to proximal portion 802 of outer tube 800.

Rotation knob 744 is rotatable with respect to articulation knob 760.Distal flange 746 of rotation assembly 740 is configured to fit withinlongitudinal gap 766 of articulation knob 760 to facilitate rotationtherebetween. Thus, rotation of rotation knob 744 with respect to handleassembly 730 does not cause any rotation of articulation knob 760.Likewise, rotation of articulation knob 760 with respect to handleassembly 730 does not cause any rotation of rotation knob 744.

Additionally, rotation knob 744 is rotatable with respect to an innershaft assembly 770. As discussed in previous embodiments above, innershaft assembly 770 is rotatable with respect to handle assembly 730 andin response to actuation of a trigger 732. A predetermined amount ofrotation of inner shaft assembly 770 with respect to handle assembly 730results in ejection of at least one anchor 100 from within anchorretaining/advancing assembly 710. Accordingly, since rotation knob 744is rotatable with respect to inner shaft assembly 770, actuation oftrigger 732 does not effect rotation of rotation knob 744 (or rotationof outer tube 800, which is rotationally fixed to rotation knob 744).Similarly, rotation of rotation knob 744 does not effect rotation ofinner shaft assembly 770.

As noted above, rotation of rotation knob 744 causes correspondingrotation of outer tube 800. Additionally, a predetermined amount ofrotation of inner shaft assembly 770 (and thus anchors 100) with respectto outer tube 800 causes distal advancement and ejection of anchor 100from within end effector 720. Accordingly, and as discussed in furtherdetail below with regard to FIGS. 71-75, if rotation knob 744 were ableto rotate beyond a particular position, the rotation of outer tube 800with respect to anchors 100 would cause at least one anchor 100 to beprematurely ejected, or may disrupt the timing of the advancement of theanchors 100 within end effector 720. Tack applier 700 of the presentdisclosure includes features that limit the amount of rotation ofrotation knob 744, and thus outer tube 800 relative to inner shaftassembly 770 and anchors 100.

As shown in FIGS. 69-70, tack applier 700 includes rotation-limitingstructure 749. Rotation-limiting structure 749 includes a firstprojection 752 a on proximal flange 750 of rotation knob 744 on firstbody half 744 a. First projection 752 a is configured to contact a firstlip 735 a within handle assembly 730 upon a predetermined amount ofrotation of rotation knob 744 in a first direction (i.e., clockwise, asshown in FIG. 64C) with respect to handle assembly 730. Contact betweenfirst projection 752 a and first lip 735 a prevents further rotation ofrotation knob 744 in the first direction, and thus limits the amountouter tube 800 can rotate with respect to anchors 100. The locations offirst projection 752 a and first lip 735 a are determined to enable aparticular amount of rotation of rotation knob 744 in the firstdirection (e.g., between about 35° and about 55°; or approximately equalto 45°; other angles are also contemplated and within the scope of thepresent disclosure).

Also, with particular reference to FIGS. 69A and 69B, rotation-limitingstructure 749 includes a second projection 752 b, which is in the sameradial orientation as first projection 752 a, on proximal flange 750 ofsecond body half 744 b. Additionally, rotation-limiting structure 749includes a second lip 735 b on handle assembly 730, which is in the sameradial orientation as first lip 735 a. Second projection 752 b ofproximal flange 750 is configured to contact second lip 735 b upon apredetermined amount of rotation of rotation knob 744 in a seconddirection (i.e., counter-clockwise, as shown in FIG. 64A) with respectto handle assembly 730. Contact between second projection 752 b andsecond lip 735 b prevents further rotation of rotation knob 744 in thesecond direction, and thus limits the amount outer tube 800 can rotatewith respect to anchors 100. The locations of second projection 752 band second lip 735 b are determined to enable a particular amount ofrotation of rotation knob 744 in the second direction (e.g., betweenabout 35° and about 55°; or approximately equal to 45°; other angles arealso contemplated and within the scope of the present disclosure).

FIGS. 71-75 further illustrate the importance of limiting the amount ofrotation of outer tube 800 with respect to anchor 100. A distal portionof outer tube 800 includes a spiral or coil 810 disposed therein. Coil810 is rotationally fixed with respect to outer tube 800. As discussedabove, rotation of inner shaft assembly 770 with respect to outer tube800 and coil 810 causes anchors 100 to rotate and advance distally dueto the engagement between head threads 114 a, 114 b of anchors 100 andcoil 810.

The position of anchor 100 with respect to coil 810 is shown in FIGS. 71and 72 when outer tube 800 has undergone no rotation. As shown, noportion of coil 810 is interfering with axial movement of thedistal-most anchor 100. Here, a first distance or first arc length “AL1”is provided between an end 811 of coil 810 and an edge 115 a of headthread 114 a. An angle “β1” is associated with first arc length “ALL”and is equal to about 60°. Other angles are also contemplated and withinthe scope of the present disclosure. As shown in this configuration,there is clearance between end 811 of coil 810 and edge 115 a of headthread 114 a, thus allowing anchor 100 to translate distally.

FIG. 73 illustrates the position of anchor 100 with respect to coil 810when outer tube 800 has been rotated clockwise with respect to anchor100 (see FIGS. 64C, 66, 68 and 70). Here, outer tube 800 has beenrotated about 45° with respect to the initial position shown in FIGS. 71and 72, resulting in a second distance or second arc length “AL2” beingdefined between end 811 of coil 810 and edge 115 a of head thread 114 a.An angle “β2” is associated with second arc length “AL2,” and is equalto about 10°. Other angles are also contemplated and within the scope ofthe present disclosure. As shown, after this amount of rotation, noportion of coil 810 is interfering with axial movement of thedistal-most anchor 100.

FIG. 74 illustrates the position of anchor 100 with respect to coil 810when outer tube 800 has been rotated counter-clockwise with respect toanchor 100 (see FIG. 64A). Here, outer tube 800 has been rotated about45° with respect to the initial position shown in FIGS. 71 and 72,resulting in a third distance or third arc length “AL3” being definedbetween end 811 of coil 810 and edge 115 a of head thread 114 a. Anangle “β3” is associated with third arc length “AL3,” and is equal toabout 105°. Other angles are also contemplated and within the scope ofthe present disclosure. As shown, after this amount of rotation, noportion of coil 810 is interfering with axial movement of thedistal-most anchor 100.

FIG. 75 illustrates a situation of what would occur if outer tube 800were rotated about 90° in a clockwise direction with respect to anchor100. (As discussed above, tack applier 700 of the present disclosure isintentionally unable to rotate this amount.) In such a situation, afterthis amount of rotation, an end portion 812 of coil 810 is disposedproximally of head thread 114 a of distal-most anchor 100, and thusinterferes with axial movement of the distal-most anchor 100. Here, thetiming of the ejection of anchor 100 is compromised since a completeactuation of trigger 732 would result in anchor 100 not fully beingreleased from tack applier 700, and the same anchor 100 being partiallywithin tissue. As a result, anchor 100 may be stuck within tissue andstuck in the thread or coil 810 of tack applier 700, for example.Additionally, if outer tube 800 were rotated about 90° in acounter-clockwise direction, the timing of the ejection of anchor 100 isalso compromised since anchor 100 would be fully released from tackapplier 700 prior to a complete actuation of trigger 732. The tackapplier 700 of the present disclosure, however, includesrotation-limiting structure 749 that limits the rotation of outer tube800 with respect to inner shaft assembly 770 and anchor 100, thus nothindering the timing of the ejection of anchor 100 from tack applier700.

As can be appreciated, securement of any of the components of thepresently disclosed devices can be effectuated using known fasteningtechniques such welding, crimping, gluing, etc. For example, it isenvisioned that outer tube 800 and coil 810 can be a single componentmade from thread rolling.

It will be understood that various modifications may be made to theembodiments disclosed herein. Therefore, the above description shouldnot be construed as limiting, but merely as exemplifications of variousembodiments. Those skilled in the art will envision other modificationswithin the scope and spirit of the claims appended thereto.

The invention claimed is:
 1. A surgical instrument configured to applytacks to tissue, the surgical instrument comprising: a handle assembly;an elongated portion extending distally from the handle assembly anddefining a first longitudinal axis; an outer tube extending distallyfrom the handle assembly; an end effector disposed adjacent a portion ofthe elongated portion and configured to house a plurality of tackstherein, the end effector defining a second longitudinal axis; arotation assembly configured to rotate at least a portion of the outertube about the first longitudinal axis and with respect to the handleassembly, the rotation assembly including a rotation knob beingrotationally fixed to a proximal portion of the outer tube; and arotation-limiting structure disposed in mechanical cooperation with atleast one of the rotation assembly and the handle assembly, andconfigured to limit an amount of rotation of the outer tube with respectto the handle assembly, the rotation-limiting structure includes: atleast one projection extending from a portion of the rotation knob; andat least one lip disposed within the handle assembly; wherein a firstprojection of the at least one projection is configured to contact afirst lip of the at least one lip upon a predetermined amount ofrotation of the rotation knob in a first direction; wherein a secondprojection of the at least one projection is configured to contact asecond lip of the at least one lip upon a predetermined amount ofrotation of the rotation knob in a second direction; and wherein thepredetermined amount of rotation of the rotation knob in the firstdirection is about 45°, and wherein the predetermined amount of rotationof the rotation knob in the second direction is about 45°.
 2. Thesurgical instrument according to claim 1, wherein the rotation knobincludes a non-circular transverse cross-section, wherein the transversecross-section is taken perpendicular to the first longitudinal axis. 3.The surgical instrument according to claim 1, wherein at least a portionof the end effector is rotationally fixed with respect to the outertube.
 4. The surgical instrument according to claim 1, wherein therotation assembly is configured to rotate at least a portion of the endeffector about the second longitudinal axis.
 5. The surgical instrumentaccording to claim 1, further comprising a plurality of helical tacksdisposed at least partially within the end effector.
 6. The surgicalinstrument according to claim 1, further comprising an articulationassembly configured to move the end effector from a first position wherethe second longitudinal axis is with coaxial the first longitudinalaxis, to a second position where the second longitudinal axis isdisposed at an angle with respect to the first longitudinal axis.
 7. Thesurgical instrument according to claim 6, wherein the articulationassembly includes an articulation knob, the articulation knob beingrotatable about the first longitudinal axis with respect to the proximalportion of the outer tube.